9 Building the quality and capacity of treatment

The Responsible Gambling Trust allocates 77% of its budget to treatment.

We welcome the progress the Trust has made in establishing and implementing a core database in the form of the Data Reporting Framework. The Trust intends to use this and other evidence to explore the impact of treatment on different groups and to investigate how the quality and effectiveness of brief interventions and more sustained treatment, residential or otherwise, can be improved. Its 2013 Commissioning Plan identified a list of areas it intended to explore, including who presents for treatment, what causes people to drop out of treatment and the cost-effectiveness of different modes of treatment. This constitutes a considerable research programme, to be scoped and resourced accordingly.

Waiting lists at Responsible Gambling Trust-funded treatment agencies are relatively short. But only a small proportion of those who would be classified as problem gamblers access such treatment. Some may not recognise the need for change. Some are likely to recover naturally, possibly as the circumstances of their life change. Some may be attempting self-help, for example through attending meetings of Gamblers Anonymous. Others will be receiving some form of intervention through the NHS, more usually directed at co-morbidities associated with problem gambling than at problem gambling itself.

It is likely, however, that a significant number of those who would benefit from treatment are not receiving it, in any form. It is also possible that there are inconsistencies in provision across the country.

In the absence of long waiting lists it is difficult to argue that more of the Responsible Gambling Trust’s limited resources should be diverted to treatment and away from prevention. That would be contrary to the principle that prevention is usually better than cure. But the absence of any significant NHS provision is striking. One of the objectives of further attempts to mainstream action on gambling-related harm will continue to be to raise awareness of the existence and size of the problem and to increase the availability of NHS and other public sector provision above its present insignificant level.

The Responsible Gambling Trust’s Harm Minimisation Projects, which are focusing on reducing the impact of gambling-related harm among vulnerable groups, could prove to be an important step towards creating an integrated and effective response to gambling-related harm across public and third sector service providers.

Indicative timescale: Work on applying new research and evaluation to commissioning processes is under way and should continue throughout 2016-17 and future years. Encouragement of public health bodies to play a greater part in treatment will largely depend on success in relation to priority action 2.

Indicators of success: A combination of research, evaluation and data collection will have created a body of evidence about the quality and effectiveness of different treatment options. More will be known about the steps that can be taken to encourage people to seek support through treatment and prevent them from dropping out. The Data Reporting Framework will be fully embedded in funded treatment provision and independent analysis will be published regularly. The learning from these activities will actively inform the Responsible Gambling Trust’s commissioning decisions.